The removal of ceramic crowns is one of the most common problems encountered in dental practice.

In particular, the removal of ceramic crowns from anterior teeth can be an aesthetically and functionally complex problem.

In this article, we will explore the causes and factors involved in ceramic crown loosening on anterior teeth, as well as ways of prevention and treatment.

Prosthetic work is intended to restore the functions of the dento-maxillary apparatus lost with the deterioration of dental units.

From improving chewing and phonation to restoring aesthetics, dental crowns play a major role in maintaining the balance of the whole body.

If these restorations target the frontal area, their deterioration produces considerable psychological sequelae.

The patient may feel shy in social situations or even isolate himself, refusing contact with other people precisely because of this problem.

This only accentuates the sense of inferiority felt by the patient.

In general, patients who are concerned about their general health and the integrity of their body and its functions will go to the dentist as a matter of urgency in the event of damage to the front group of teeth.

Edentations or lesions that cause extensive destruction affect mastication, phonation and aesthetics.

The loosening of prosthetic work, in the frontal areas, may be due to compressive forces that produce changes in the cementing material. On the other hand, some compromises made during the clinical and technical stages may also have consequences on the finished piece.

There are a number of causes and factors that can contribute to the de-cementing of ceramic crowns on anterior teeth.

Risk factors

• Lack of retention of the prosthetic piece to the prosthetic abutment – there may be defects in the tooth surfaces which, with correction, solve the problem. There is a situation where the prosthetic piece is much wider than the tooth to which it is attached and by applying a thicker layer of cementing material the strength of the tooth is weakened.

• Defects at the time of cementation – the cementation of a prosthetic work must respect an environment isolated as far as possible from oral fluids. Saliva penetration either by tongue wandering during the cementing process or by lack of isolation with cotton wool rolls can lead to compromised adhesion.

• Patient occlusal problems – deficiencies in the patient’s occlusion caused by dental, muscular or bony abnormalities can lead to paraxial, inconsistent forces that contribute to the dehiscence of prosthetic work.

• Evolution of a cavity on the prepared tooth – teeth must be prepared for crowns.

This means reducing the overall size of the teeth by about 2 millimeters for ceramic crowns.

If the teeth undergo carious processes, these must be thoroughly cleaned and filled because once the ceramic crown is applied, any active carious process can erode further from the tooth surface, leading to the removal of the prosthetic crowns.

• Lack of adhesion of the cementing material to the tooth surface – the cementing material is interposed at two surfaces, the teeth and the prosthetic work. Inadequate cleaning of these two planes or chemical interference can lead to poor adhesion which, over time, can promote loosening.

The patient may be able to tell for themselves the poor adhesion between the prosthetic restoration and the tooth by the appearance of mobility.

Halitosis may also be a sign of infiltration of cementing material.

On the other hand, if the denture is over cemented, i.e. the patient feels that it closes on that denture tooth first and only then on the rest, it may be due to partial loosening of the denture.

The loosening of ceramic crowns is one of the most common problems encountered in dental practice.

In particular, the removal of ceramic crowns from anterior teeth can be an aesthetically and functionally complex problem. In this article, we will explore the causes and factors involved in ceramic crown loosening on anterior teeth, as well as ways of prevention and treatment.

Causes

• Excessive or incorrect masticatory forces, which can cause fractures or wear of the crowns;

• Dental abrasion, which can affect crown adhesion;

• Insufficiently prepared or adapted crowns, which can cause overloading of crown margins;

• Problems with cementing crowns, such as using the wrong cement or applying cement improperly.

Prevention

Preventing the loosening of ceramic crowns to prevent the loosening of ceramic crowns, it is important to take precautions during the preparation and cementation of crowns. These include:

• Proper tooth preparation, which ensures optimal crown adhesion;

• Use of an appropriate cement for ceramic crowns;

• Proper cementing of crowns, ensuring that cement is applied evenly and that there is no gap between the crown and the tooth;

• Controlling occlusal forces, ensuring that the patient has a correct occlusion and that there is no overloading of the crown margins.

Therapeutic management

If the ceramic crown becomes dislodged, treatment depends on the causes and degree of damage.

If the crown is intact and only the cement has eroded, it can be cemented back in. However, if the crown has been fractured or has suffered significant wear, it may need to be replaced.

If neighboring teeth have suffered wear or fracture, restorative work may be required to ensure adequate occlusion.

Decay of ceramic crowns on anterior teeth is a common problem encountered